Asthma & Mobile Technology II – PediaCast 295

Dr David Stukus and Dr Nabeel Farooqui join Dr Mike in the PediaCast Studio to talk about asthma and mobile technology. In addition to the cause, diagnosis and treatment of asthma, we’ll discuss how mobile app technology is making it easier for young patients and parents to manage this common disease.

Topics

  • Asthma
  • Asthma Action Plan
  • Mobile Technology
  • Mobile Apps
  • Fall Family Fun

Guests

Links

 

CONTACT DR MIKE – Ask Questions, Suggest Show Topics

CONNECT NOW with an asthma specialist from Nationwide Children’s – Referrals and Appointments

Transcription

Announcer 1: This is PediaCast.

[Music]

Announcer 2: Welcome to PediaCast, a pediatric podcast for parents. And now, direct from the campus of Nationwide Children’s, here is your host, Dr. Mike.

Dr. Mike Patrick: Hello, everyone, and welcome once again to PediaCast. It’s a pediatric podcasts for moms and dads, This is Dr. Mike, coming to you from the campus of Nationwide Children’s Hospital on Columbus, Ohio. It is September 10th, 2014, Episode 295. We’re calling this one “Asthma and Mobile Technology Part 2”.

I want to welcome everyone to the show. So, Labor Day here in the United States is behind us, and the kids are back in school. We’re heading into autumn here in the Midwest, which is my personal favorite time of the year. Anyway, with college football underway, it will soon be time to break out the sweatshirts. I think we got a few weeks left on that. We got a bit of hot weather still coming through.

But I have to say, really, compared when we lived in Florida, I really enjoy having four distinct seasons. In Florida, there were only three seasons. We have warm and rainy, pretty hot, and then unbearably hot. And although, the high was not perfect, seems the winter and the spring transition less a little too long for my liking, and those of you who live in Ohio knows exactly what I’m talking about.

But the fall season definitely makes up for it. We have Ohio State football. We got corn mazes and hay rides, apple picking, apple cider, and of course, Halloween candy. Even though we talk about good nutrition, you got to splurge sometimes. Again, I love this time of year, and stay tuned at the end of the program, we’ll talk a little bit more about some fun family activities in the fall.

0:02:01

Our topic today — and it’s an appropriate one for autumn and the upcoming winter — is asthma. We’re going to cover the nuts and bolts of the disease. And we’ll also update you on the Asthma Care mobile app from Nationwide Children’s, which is designed to help young patients, parents, and pediatric health care providers as they deal with asthma management. To help me talk about these things, I have two allergy and asthma specialists from Nationwide Children’s joining me in the studio, Dr. David Stukus and Dr. Nabeel Farooqui. So that discussion is coming your way soon.

First, I do want to remind you that our 700 Children’s Blog, kind of the sibling blog to the podcast, it’s available over at 700childrens.org. Some recent topics: how to deal with adolescent depression — that’s a tough one for many families out there, and we’ll give you some hints on what to watch for, who to see, and how it’s treated — and then, athletes and hydrating, what you need to know.

Football and cross country running are in full swing. And of course, we don’t want to see any heat exhaustion or heat stroke out there. It’s important to say hydrated during practice and competition, but we also don’t want kids overhydrating. And yes, you can do that. It can be dangerous,. We’ll give you some tips on how much water is enough and how much is too much.

And then, child product recalls. As parents, we want the best for our children, and when it comes to their safety, we like to think we’ve done our homework and learn about the safest products for our children to sleep on, ride in, ride on, bathe in, play with and wear. But sometimes, even the most trusted companies have products with defects and things we bought end up being recalled. So how is a parent to keep up on the safety warnings, we’ll fill you in.

And again, you can find these stories and more in our 700 Children’s Blog, which you can find at 700childrens.org.

I want to remind you that PediaCast is your show, so if you do have a question for me, or you have a topic idea for a program, or you want to point me in the direction of a news article or journal article that you think parents would benefit from hearing about, it’s easy to get in touch. Just head over to pediacast.org, and click on the Contact link.

0:04:07

Also, I want to remind you, the information presented in every episode of PediaCast is for general educational purposes only. We do not diagnose medical conditions or formulate treatment plans for specific individuals. So if you have a concern about your child’s health, be sure to call your doctor and arrange a face-to-face interview and hands-on physical examination. Also, your use of this audio program is subject to the PediaCast Terms of Use Agreement, which you can find at pediacast.org.

All right, let’s take a quick break and we’ll get Dr, Stukus and Dr. Farooqui settled in to the studio. And we’ll talk about asthma right after this.

[Music]

Dr. Mike Patrick: All right, we are back. Dr. David Stukus is an attending physician with the Section of Allergy and Immunology at Nationwide Children’s Hospital and an assistant professor of Pediatrics at the Ohio State University College of Medicine. He is no stranger to PediaCast or social media for that matter. He has previously joined me to talk about asthma in Episode 242, as well as seasonal allergies back in Episode 264. He also maintains an active and popular Twitter handle, @AllergyKidsDoc. It’s all one word, AllergyKidsDoc.

So let’s give a warm PediaCast welcome to Dr. David Stukus. Thanks for joining me again.

Dr. David Stukus: Thank you for the invitation. It’s a pleasure to be here.

Dr. Mike Patrick: Really appreciate you stopping by.

And then, Dr. Nabeel Farooqui, also joins us today. He completed his Allergy and Immunology fellowship at the Ohio State University and Nationwide Children’s Hospital, and he’s also a repeat PediaCast guest. You recall Dr. Farooqui joined us back in Episode 242 when he shared his vision for a pediatric asthma mobile app. That dream is a reality and we look forward to hearing how the technology is working out and how families can connect and use it.

So let’s also give a warm PediaCast welcome to Dr. Dr. Nabeel Farooqui. Thanks for stopping by.

0:06:16

Dr. Nabeel Farooqui: Thank you very much, Dr. Mike.

Dr. Mike Patrick: Really appreciate it.

So, it’s been awhile since we talked about asthma, and even though we have covered this disease in the past, it’s such a common problem and has the potential to be a dangerous problem. So, before we get to our discussion on mobile technology, I really just wanted to hit the nuts and bolts of asthma again, especially as we head into the fall and winter season.

So, Dr. Stukus, if you could just start out, just give us sort of a definition. What is meant by the term ‘asthma’?

Dr. David Stukus: Sure, so asthma is actually defined by two things. One is chronic inflammation and irritation of the lower airways that’s hallmarked by recurrent and reversible episodes of what’s called bronchoconstriction or really tightening of the airways. So this isn’t just a onetime episode of coughing, wheezing. These are episodes or symptoms that come back over and over and over again.

Dr. Mike Patrick: Now, a lot of doctors use the term ‘reactive airway disease’ and I’m sure parents have heard that. Is that the same thing as asthma? How is it different?

Dr. David Stukus: Reactive airways disease is really asthma. It’s just called something different. So we make every effort we can to actually diagnose it as asthma, because I think that really conveys the importance of being prepared, recognizing symptoms, and that you guys should do something about it.

Dr. Mike Patrick: How common is this condition?

Dr. David Stukus: Unfortunately, it’s very common. So it’s about 10% of the general population. So, it’s really three children on average in every classroom in America. And then, in some areas such as inner city populations, it can be as high as 20% or 30% of children with asthma.

Dr. Mike Patrick: Yeah, that is a lot. Do you see a difference among different ethnic groups, or is that pretty much across the board in the United States anyway?

Dr. David Stukus: No. There are big disparities depending upon ethnicity. African-Americans and Hispanics are at a higher risk of developing asthma. Also, where you grow up, so inner city population, proximity to highways and inner states, locations where there’s a lot of air pollution have higher risk of asthma as well.

Dr. Mike Patrick: Do you see a difference between males and females? Or are boys and girls affected pretty equally there?

0:08:11

Dr. David Stukus: Boys tend to dominate when they’re younger, and then once puberty had set sort of even outs, and then it tends to affect girls more commonly after adolescence.

Dr. Mike Patrick: And I suspect there’s probably some genetic component involved as well, since you see asthma running in some families.

Dr. David Stukus: Absolutely. So genetics really drive for the development of asthma, and what we think is really the factors, your DNA blueprint — so what you’re born with mom and dad — and then early life exposures. Sometimes even exposures when babies were in the womb, before they even come out in the world.

Dr. Mike Patrick: Here’s a million-dollar question. Do you think the prevalence of asthma is increasing? And if so, why would that be?

Dr. David Stukus: I can answer that very easily. Yes.

[Laughter]

Dr. David Stukus: Now, the reason why, how long do we have? So there are no clear-cut answers. The most prevailing hypothesis, and it’s really a hypothesis, is something called the hygiene hypothesis. So, we know that allergies, food allergies, especially asthma are all on the rise the last couple of decades. And what the hygiene hypothesis proposes is that as society has become cleaner — we moved away from living on farms, rural environments — our immune systems are no longer challenged by microbes and germs and something called endotoxins. So our bodies aren’t fighting off infection and our immune systems are becoming re-programmed to sort of react against benign stimulant like pollen, and food allergens, and things like that. So there’s been a real shift.

Dr. Mike Patrick: Not to put a personality on immune system, but if it’s busy fighting off microbes, then it kind of ignores the stuff that were around. But if it’s not busy fighting microbes, it starts paying attention to other normal things that are there.

Dr. David Stukus: I like to think that it gets bored and then it resorts to act out.

[Laughter]

Dr. Mike Patrick: If we travel down into the lungs, more of the tissue level, even the cellular level, what really is causing the symptoms that we see? What is it that makes kids wheeze?

0:10:05

Dr. David Stukus: So they always have this inflammation and irritation, and that causes swelling in just very angry and hyper-reactive airways. And then, what causes the actual symptoms will be squeezing and tightening of the airways themselves. In addition, the mucus that children or anybody with asthma produces is very different from other types of mucus. It’s sticky, it’s disgusting, it’s really hard to clear out of the airways. So, not only do you have tightening and airflow constriction, obstruction but you also can’t get this disgusting mucus out of the airways as well.

Dr. Mike Patrick: How do you go about diagnosing that then? If you have a child who is coughing, maybe having a little trouble breathing, maybe they’re wheezing, how do you tell that’s asthma?

Dr. David Stukus: So, the history is the most important, especially in younger children. It’s really what are the symptoms, what’s triggering the symptoms, how often are they occurring. I like to cheat as much as I can. What kind of treatment have you tried so far? If you haven’t tried any treatment yet, I often recommend trying a medication like albuterol , which is a bronchodilator, so next time coughing or wheezing happen, you can try it. See if it actually helps and pay attention to that. That can really help us out with the diagnosis.

And then, when people get older, generally about five years of age, a little bit older, you can do lung function testing. That can very helpful to determine whether there’s obstruction present. We have a couple other cool tools in our utility belt as well, something called exhaled nitric oxide, which we’re still trying to figure out the clinical usefulness, but that can help show whether or not there’s a lot cells called eosinophils that go along with allergic inflammation in the airways. So we have quite a few tools.

Dr. Mike Patrick: It seems this time of the year, asthma starts picking up, we start to see a lot more kids who are wheezing and have breathing difficulties in pediatric offices, in urgent cares, the emergency department. Why is it that things seem to be getting worse this time of the year?

Dr. David Stukus: You mentioned our wonderful 700 Children’s Blog. I’ll put a plugin for my own back-to-school with asthma post on our website. It is very common. Hospital rates, emergency room visits go through the roof every September and October, and again peaky on the spring for three main reasons. One would be going back to school, you get to be exposed to a lot of different viruses and viral infections. Even the common cold are one of the common causes of asthma in severe asthma episodes.

0:12:17

Second is we get crazy weather. All these rapid changes in the weather, hot or cold, cold or hot, cold fronts running through a rainy weather, that can all trigger asthma symptoms as well.

And then, lastly, there are a couple of dominant outdoor allergens such as ragweed and mold spores that can really trigger asthma episodes for a lot of people who have allergies and asthma.

Dr. Mike Patrick: I heard recently through someone on Twitter that the mold spores are really bad this time of the year because of all the rain that we’ve had here in Central Ohio.

Dr. David Stukus: Right. So, right now, on dry days, it’s going to be ragweed, and on wet days, it’s going to be molds.

[Laughter]

Dr. Mike Patrick: You can’t win for losing.

Dr. David Stukus: Can’t catch a break.

Dr. Mike Patrick: Let’s talk a little bit about asthma treatment. You mentioned bronchodilators. How do those work?

Dr. David Stukus: Those are medications by either an inhaler or through a nebulizer machine, and the medicine gets inside the lungs and acts very quickly to help open up the airways that are being squeezed and tightened due to constriction.

Dr. Mike Patrick: So this is what we would consider a rescue medicine. It’s something that’s going to have an immediate effect.

Dr. David Stukus: That’s correct.

Dr. Mike Patrick: What about steroids? Where do they play a role in the treatment of asthma?

Dr. David Stukus: For anybody who has persistent asthma — which is really defined by needing albuterol as a reliever medicine more than twice a week on average, waking up at night to do and cough and wheezing, difficulty breathing more than twice a month on average, or having extreme limitations on their activity, or need prednisone or oral steroids more than once or twice a year — they would benefit from use of a daily controller therapy. And across the board, inhaled corticosteroids are the most effective type of controller medicine that really decrease that inflammation that we talked about earlier.

Dr. Mike Patrick: And then, some parents kind of bulk at the idea of their kid being on a daily steroid. Is that safe?

Dr. David Stukus: It is very safe. So the doses that we use are really diluted down significantly and delivered right to the lungs. It’s very important that you use the appropriate technique, and we generally recommend that you use a spacer or a holding chamber with any type of meter-dosed inhaler to make sure the medicine gets inside the lungs as opposed to being swallowed in the stomach. But the doses that we use are much, much safer than what we give by mouth or through an IV.

Dr. Mike Patrick: What points would you need to give a dose of steroid by mouth or through an IV?

0:14:27

Dr. David Stukus: So, if you’re having acute asthma episode that is either prolonged or very severe , where the albuterol medicine isn’t working or you’re needing it more frequently than the recommended every four hour or so, that would be an indication. So, generally, you’re going to have pretty severe cough. Sometimes it’s not even wheezing, it’s just coughing that you’ll notice. And then, a late sign would be if you’re using the extra muscles in your ribs or above your sternum to really help suck in that extra air in your lungs we call as retractions.

Dr. Mike Patrick: So kids who are on just albuterol, let’s say a couple of times a week, they have to use their inhaler or they end up in the emergency department once a month, and they get those oral steroids, at some point, then it is going to be better to have them on the daily low-dose steroid.

Dr. David Stukus: Without a doubt. It’s really important for both parents, also anybody who suffers from asthma, and then the clinicians and providers alike to recognize that number one, if things aren’t going well in regards to asthma; number two, that we can do better. There are families out there — and it is a generational thing, grandparents, and parents, and siblings — that just think it is normal to have to go to the emergency room for asthma. And we can do better.

Dr. Mike Patrick: What is the long-term outlook for kids with asthma? Is this something that a lot of kids then outgrow or is this something that they’re going to have their whole life?

Dr. David Stukus: It’s across the board. A lot of children will actually outgrow it and have decrease in symptoms or lose all their symptoms entirely as they get older. Other children, what we call the “allergic march” — so if they have a history of eczema, other types of allergies such as environmental allergies, food allergies, and they develop asthma — tend to have more persistent disease, even lifelong.

0:16:04

Dr. Mike Patrick: Dr. Farooqui, let’s move in to our discussion on mobile technology here. As we think about asthma and asthma treatment, how does mobile technology fit in to education and treatment strategies?

Dr. Nabeel Farooqui: So, asthma is really unique in that it really requires active involvement from the patient, such as monitoring their symptoms, knowing when to use a rescue inhaler, using their medications on time. And we know that non-adherence with these asthma treatment plans can lead to poor asthma outcomes.

We’ve also found over the generations that kids of younger and younger age are being exposed to technology, whether it’s their parent’s phones or iPads or whatever, and there’s a lot of educational tools which are very useful. So, the trick is really to leverage this to increase patient engagement with their health condition improved adherence and ultimately ask for control. So various strategies which are being used right now are things like electronic dose counters, software apps for smartphones, little peripheral devices which can go on inhalers like little GlowCaps and things like that.

Dr. Mike Patrick: Now, in terms of asthma specifically, why target asthma with mobile technology? What about the disease makes this a good fit for coming up with a mobile app?

Dr. Nabeel Farooqui: One of the things that we talked about, actually spent the most time with our patients in the clinic is to educate them, number one. And number two, to get them involved with their health. Unless they really understand what’s going on and why it’s important for them to take the medication on time and how to address acute symptoms, they’re not going to be able to get their asthma under control. So we kind of give them the tools that they need to just take things for themselves and really get them involved.

Dr. Mike Patrick: Some diseases, you get diagnosed with the disease, you take the medicine and while you’re on the medicine, things are better as long as you… But asthma is really one of these kind of roller coaster where you’re almost dealing with it in some way or another every day, or sort of thinking about it or you need to be thinking about it. Kind of diabetes in that sense, too.

Dr. Nabeel Farooqui: Absolutely.

0:18:15

Dr. Mike Patrick: So I could see why it would be good to have something in your pocket to help you manage that.

Tell us about the mobile app that’s available to asthma patients here at Nationwide Children’s.

Dr. Nabeel Farooqui: Absolutely. So Asthma Care’s the name of the mobile apps that Dave and I developed. So, these are built on proprietary platform which has been licensed specifically for Nationwide Children’s. So right now, in its current form, it’s out for iOS, but as we speak, development for an Android version is in the works.

I think what sets this apart from all other apps out there is that it was designed from the ground up by asthma specialists. I think we are pretty in tuned with what our patients need and the approach that we took to creating this was built and centered all around that, as opposed to being built by a technology company.

So, the content is all based on the latest evidence-based medicine, and it’s also presented in a way which is really easy for our patients to follow along. Sometimes, the content is just so medically heavy and it’s got medical terms and jargon in there, and patients may not really connect with it. So we took that a step further and made it really easy-to-use graphical interface. The graphics are very pleasing, especially for our demographic here at Nationwide Children’s.

Initially, when the user first start up their app, they’re greeted by their asthma buddy, Sam, who sets up their user profile. So the user enters in their name, their daily controller medication, the dose and specific asthma triggers that may set off their asthma. So, the app is actually personalized for each patient and different for every patient. Once the profile is set up, they are taken to the dashboard, which has different sections showing their active zone of control, list of medications that they’re on so they’re continually seeing their medications, receiving reminders either daily or twice daily of when to take the medicine. So there’s active education going on.

0:20:03

There’s also trigger reminders, push notifications to teach them about how to avoid their certain allergens. And then, finally, they can actually enter in their symptoms and the use of their rescue medications. So we put a lot of work into developing an algorithm which actually list their zone of control and will give them real-time feedback on what to do based on their current symptoms.

Dr. Mike Patrick: When you talk about zone of control, what is that?

Dr. Nabeel Farooqui: One of the things that is actually in the app’s asthma guidelines is the use of an asthma action plan. It has three different zone, green, yellow and red, depending on how your symptoms are doing and depending on how much rescue medication you’re using. So, if everything is doing great, you’re not having symptoms or requiring any rescue medicine, you’re in the green zone. So, it’s recommended to keep using your controller medication.

As soon as you have an acute loss of control, as we call it, and having a little bit of symptoms, you can use acute rescue medication. And then finally, in the red zone, if you’re in a lot of trouble, having a cold for example, and your rescue medicine is just not working, then at that time, you need to call your doctor for help, for the recommendations or so.

Dr. Mike Patrick: So, really, they have that plan in their pocket and they can look at what symptoms they have and what they should be doing. It looks like it’s great from the patient point-of-view. How does this app then help pediatric healthcare providers?

Dr. Nabeel Farooqui: Pediatric healthcare providers, it’s really neat. It’s kind of a double-edge sword. On the one hand, it’s great and at the app, we’ve actually built in functionality where it can print out a patient’s report card showing what symptoms they have been experiencing, how they’ve been using their medications on time and how much rescue medicine they’ve been using. And that report is then emailed to a provider.

On the converse end, the question then that comes up is who is the provider that is going to be responsible for that? What are they going to do with that information? Are they going to be responsible for calling the patient and making sure they’re OK? So this is definitely a conversation which every doctor needs to have with their patients to make sure that they have that good plan in place, that if something goes wrong, then the appropriate steps are taken to get things under control.

0:22:11

Dr. Mike Patrick: Yeah, absolutely. And I could see where, when we talk about if your asthma’s out of control more than a couple of times a week, or you have night time symptoms more than a couple of times a month. As a patient is in the office, thinking back, they may not think accurately or may either exaggerate it or on the other side, they may kind of say that it’s not bad as it was, what it really is. So here, you really have some objective data, as long as they’re keeping up with it, that the doctor can use to help with management.

Dr. Nabeel Farooqui: Absolutely. I mean it’s a very accurate and electronic sort of asthma journal that we often ask our patients to keep in-clinic.

Dr. Mike Patrick: Are there pitfalls? One is who’s going to look at this report that goes out? Are there any other pitfalls for the parents and the family in using something like this?

Dr. Nabeel Farooqui: At the end of the day, just like they said, asthma is a clinical diagnosis. This is not a replacement for your doctor. So at any point, things are out of control and you’re having any questions, then definitely call up your doctor. And that’s a disclaimer that we put in the app itself. This is just a tool to help you manage things, but it is not a replacement for an actual clinic visit.

Dr. Mike Patrick: And from the provider standpoint, I supposed there’s some pitfalls as well. Each kid is different and you are trying to say each kid has to fit in to this plan and maybe they don’t have the right plan.

Dr. Nabeel Farooqui: I think the biggest thing that we can do is to be informed. The patients that we’re dealing with these days are very different from the patients 20, 30 years ago, even 10 years ago. They’re doing Google searches, they’re using smartphone apps. They’re using peripheral devices on their inhalers. Unless we know what things they’re being exposed to, we’re not going to know how to tackle it. And I think that’s very important because many of these things are actually not based on sound medicine. They may just be random pieces of information and may actually lead to harm. So, unless we know what’s out there, we won’t be able to give them informed decisions on what they should and should not be using.

0:24:18

Dr. Mike Patrick: How has the app been received by patients and parents?

Dr. Nabeel Farooqui: The response of the app has been absolutely phenomenal, we couldn’t be happier. So we actually just finished a 30-day pilot study in which we were looking at the usability, patterns, and acceptability of the app. Across the board, the response was overwhelming. Patients were using their medications on time. They were getting rewards, which were taking them to either the highest tier or like the second highest tier, showing us that they were compliant with he medications. They were using it multiple times in a day. We actually showed an increase in their education level, that they were actually gaining techniques on how to avoid their certain allergens.

Everyone really connected with the media format of receiving information. So, they actually prefer using this format of an asthma action plan as opposed to traditional paper asthma action plan, which many of them didn’t even know how to use or didn’t even know what it was once they got home. And almost everyone said that they would recommend this further to friends and family. So, just going along the same lines with we’re dealing with a different generation and I think we need to adopt our educational tools as such.

Dr. Mike Patrick: Yeah, absolutely. Now, is this something that is only available for patients in the Asthma Program here at Nationwide Children’s? Or can parents who have kids with asthma anywhere use it?

Dr. Nabeel Farooqui: So right now, it’s available to all asthma patients throughout the Nationwide Hospital. So whether that’s urgent care close to home, emergency department, primary care network or specialty clinic, you can download it from our website at www.nationwidechildrens.org/asthmacare. And soon, we’re going to be having a commercial version available for general use.

Dr. Mike Patrick: And I’ll put a link to that so people can find it easily on the website.

0:26:06

In Central Ohio, there are a lot of kids with mild asthma who may not need to see an asthma specialist. So their family practice doctor or their pediatrician is managing their asthma. Is this something then that they would be able to use as well?

Dr. Nabeel Farooqui: Absolutely. The same basic foundation and fundamentals of Asthma Care are the same, regardless of if you have very mild asthma or very difficult-to-control asthma. You still want to take your medications on time. You want to be vigilant about your symptoms and know when you’re in trouble and know what to do when actually when you actually have trouble.

Dr. Mike Patrick: Yeah. That’s great. I’m really excited about this app, and I hope more families are able to take advantage of it. Again, we’ll put the link on how people can get connected with it and unable to use it.

Dr. Stukus, tell us a little bit about the Asthma Program here at Nationwide Children’s Hospital.

Dr. David Stukus: Sure. So asthma is a top priority throughout our institution because it’s a leading cause of emergency room visits and patient hospitalization, and just kids don’t feel well when they have poorly controlled asthma. So there are efforts on multiple fronts. Pretty much anywhere that you present through our hospital, anyone who takes care of asthma, is doing some sort of initiative to really improve the control of asthma.

Then we have Complex Asthma Clinic that I help run with Tiffany Turner, one of our pulmonologists. So one-half day a week, we see the sickest of the sick, patients who require multiple ER visits or intensive care unit stays or hospitalization for their asthma. We have a dedicated asthma clinic with nurses and we can do comprehensive testing and treatment options and social workers and things like that. So it’s been a very worthwhile endeavor so far.

And then, we have a our sub-specialty clinics through Allergy and Immunology and also Pulmonary, where patients can be seen and can also benefit from additional specialist treatment. Our primary care network has an entire initiative surrounding asthma, including Fall Focus. So they’ve been reaching out to patients proactively and trying to get them in around this time of the year to really talk about their asthma and address all those things we talked about before of being aware of weather changes and viral infections, making sure their action plan is up-to-date, making sure they’re on the right therapy, things like that.

0:28:12

And then, we even have initiatives for when you walk through our door in the Emergency Department. We try to get you oral steroids within the first hour because that’s been shown to help decrease the rates of hospitalization. And we’re actively looking at, on a regular basis, are we doing the right things? Looking through the literature in other institutions throughout the country and the world, what are they doing to help treat their patients with asthma, both acutely and chronically and can we do better?

Dr. Mike Patrick: I suspect that there’s a lot of families out there who limit their child’s activities because they have asthma. And I think that’s another place, where really getting yourself educated, getting plugged in to an asthma program, I wonder if families who are plugged in that way are more likely to encourage their kids still to be involved and do things, and be active despite their asthma.

Dr. David Stukus: Absolutely, that makes me cringe every time I hear that, when a child is told not to exercise of play sports because of their asthma. That’s absolutely… That can’t be further from the truth.

It really starts also with the level of where they’re getting their education. So we’re trying to make a comprehensive effort through every place at Nationwide Children’s Hospital, that touches asthma — are we sending the same clear evidence-based message to families — and we’re doing everything we can to make sure that happens.

Dr. Mike Patrick: Great. That’s fantastic. And we’ll put links in the Show Notes. So folks, head over to pediacast.org and find the Show Notes for this episode, which is 295. We’ll have links to the Asthma Program here at Nationwide Children’s, also a link to the Asthma Care app from Nationwide Children’s. And then, we’ll also have a link to Dr. Stukus on Twitter, @AllergyKidsDoc. It’s a great feed to follow.

And then, we also have our Connect Now With An Asthma Specialist from Nationwide Children’s. So that’s a link that you can click if you’re interested in a referral for one of your patients, if you’re a pediatric healthcare provider. Or if you’re a patient and you’d like to make an appointment with the Asthma Program, again you can just click Connect Now With An Asthma Specialist from Nationwide Children’s, and they’ll take you to our Welcome Center, where you can put in your information and someone from the hospital will contact you and just help facilitate making referrals and appointments happen. So we’ll put that in the Show Notes as well.

0:30:22

All right, and I meant to warn both of you before the program about this.

Dr. David Stukus: Oh oh, are you doing the ice bucket challenge with us?

Dr. Mike Patrick: No, no, no, we’re not going there.

[Laughter]

Dr. David Stukus: We’ve already done that.

Dr. Mike Patrick: Yeah, we’re not going there.

One of the things that really means a lot to me is really promoting families doing stuff together that doesn’t involve video screens and computers and televisions and that sort of thing. And with fall coming up, I just thought we could all share some of our favorite family activities to do in the fall. So, I’ll do mine first, so that you guys can think about it.

There is a place between if you’re in Central Ohio. And I don’t get any kickbacks from this place. Disclaimers, I don’t have family member who owns it or anything like that. But there’s a place called Young’s Jersey Dairy that is between Springfield and Yellow Spring on Route 68. It’s about an hour’s drive from Central Ohio. But our family loves going there and in the fall, they have corn mazes and hay ride. It’s a real working dairy, plus they have two miniature golf courses and batting cages, and just lots of fall fun. I think we always make a trip out there in the fall. That’s probably our fun way to spend an afternoon in October.

What about you guys, what do you like to do in the fall?

Dr. David Stukus: So I’ll go the other direction. I’ll go a little bit east of Columbus. And again, I get incentives or kickbacks, but Lynd’s Fruit Farm just outside of Johnstown, I believe, that whole area. It’s a fantastic place to go apple picking. I’ll put a plugin for the Nationwide Children’s Hospital Pumpkinpalooza which I believe is on September 27th this year, and it’s fantastic for the kids. You can pick pumpkins, get hay rides. There’s a corn maze, you name it. And that really for us kicks off the fall season. We just love it.

0:32:15

Dr. Mike Patrick: I think that I received in my email a link to information about the Pumpkinpalooza, and so I’ll put that in the Show Notes as well, so people can find that very easily.

Dr. Farooqui, what about you?

Dr. Nabeel Farooqui: So I’m lucky. I don’t have to make up one hour of commute outside of Columbus to go to my go-to. So, Jacquemin Farms, which is just off of Hyland Croy Road behind my house.

Dr. Mike Patrick: Oh, wow.

Dr. Nabeel Farooqui: Me and my kids always ride our bikes there, have fresh donuts from the seasonal fruit that they’re growing at that time, Saturday mornings. And come fall time, they have pumpkin patches. You can pick your own berries and strawberries and apples, and have corn mazes, and just a great time. They have bounce houses for kids and everything.

Dr. Mike Patrick: What’s the name of it again?

Dr. Nabeel Farooqui: Jacquemin Farms.

Dr. Mike Patrick: OK, I’ll put a link to all these things in the Show Notes so people can find it easily. That’s great, just to get outside and enjoy the fall weather. It still feels like summer I think right now, but it’s not going to be long. And we’ll break up the sweat shirt here soon.

Well, we appreciate both of you stopping by and talking on asthma and the mobile apps. Really appreciate it.

Dr. Nabeel Farooqui: Thank you so much for having us.

Dr. David Stukus: It was a real pleasure. Thank you so much.

Dr. Mike Patrick: Yeah, absolutely. Let’s take a quick break and I will be back. We’ll wrap up the show right after this.

[Music]

0:34:07

Dr. Mike Patrick: All right, we are back with just enough time to say goodbye. I do want to thank Dr. David Stukus and Dr. Nabeel Farooqui, both allergy and immunology doctors here at Nationwide Children’s Hospital. I just thank both of them so much for coming and talking about asthma and our Asthma Care mobile app. That does wrap our time together.

PediaCast is a production of Nationwide Children’s Hospital. Don’t forget, PediaCast and our single-topic short format program, PediaBytes, are both available on iHeartRadio Talk which you’ll find on the Web at iHeart.com, and iHeartRadio app for mobile devices.

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And until next time, this is Dr. Mike, saying stay safe, stay healthy and stay involved with your kids. So long, everybody.

[Music]

Announcer 2: This program is a production of Nationwide Children’s. Thanks for listening. We’ll see you next time on PediaCast.

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